A patient with metastasized cancer says to the nurse, I've been ...

[kodithompson]

A patient with metastasized cancer says to the nurse, I've been reading about some of the cancer research, and I am still hoping for a cure in the next few months..
 
  In formulating a response to the patient, which should the nurse consider first? a. The patient's religion and/or faith-based beliefs
  b. The need for a consultation with a professional grief counselor
  c. The purpose that would be served in confronting the patient's denial
  d. The patient's ability to understand the meaning of this particular research

Question 2

You are the nurse working at a homeless shelter. You begin working with a homeless person who has been diagnosed as having paranoid schizophrenia. This client believes that everyone is trying to poison him.
 
  He comes to the shelter once or twice a week to eat the evening meal, which is soup. This client believes that soup is the only food that is not poisoned. An appropriate short-term outcome for this client would be that the client will: a. have decreased or absent delusions within 2 weeks
  b. agree to take antipsychotic medication daily
  c. eat food other than soup within 1 week
  d. agree to meet with the nurse when he comes to eat

[sabina576]

Answer to Question 1

C
Having hope against hope may not mean that the patient is in denial, but rather that he or she is using denial as an adaptive defense mechanism. The nurse should first consider what purpose confrontation would serve at this time.

Answer to Question 2

D
Agreeing to meet with the nurse when the client comes to the homeless shelter is a short-term goal that could possibly be achieved in a short period of time. Because the client is paranoid, it may take developing a relationship with the nurse before the client will agree to take medication and eat food other than soup. The goal to have decreased delusions within 2 weeks may not be reasonable until the other three goals have been met.